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Organization
CYBER MEDICAL GROUP LLC
Active
Organization
CYBER MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR PRUS (PRESIDENT)
(414) 215-4419
Entity
Organization
Contact information
Practice address
5067 N LINCOLN AVE APT 201, CHICAGO, IL 60625-8188
(414) 215-4419
Mailing address
5067 N LINCOLN AVE APT 201, CHICAGO, IL 60625-8188
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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